| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $175.00 | $175.00 | $388.73 | |
Aetna
| Professional | $175.00 | $175.00 | $175.00 | |
Cigna
| Facility | $234.91 | $241.61 | $757.25 | |
Cigna
| Professional | $126.34 | $295.27 | $502.64 | |
Regence BlueShield
| Facility | $274.83 | $316.05 | $1,113.06 | |
Regence BlueShield
| Professional | $274.83 | $304.48 | $382.04 | |
United
| Professional | $115.43 | $115.43 | $164.90 |